A separate non-network annual deductible in the amount of $600 per individual ($1,800 per family) will apply. The non-network annual deductible will apply toward the network deductible.
The individual network annual out-of-pocket maximum will remain $2,000. The network annual out-of-pocket maximum for a family will increase from $4,000 per family or two or more to $6,000 per family of three or more.
The individual non-network annual out-of-pocket maximum will increase from $2,000 per individual ($4,000 per family) to $4,000 per individual ($12,000 per family). Non-network out-of-pocket charges will apply toward the network maximum.
HMO - No changes in network.
Prescription Drug Program will be revised as described below:
Prescription drugs purchased at a participating pharmacy will be covered as follows:
$5 copayment generic. $20 copayment brand formulary (currently $15 copayment).
$35 copayment brand nonformulary (currently $30 copayment).
30 day supply.
Prescription drugs purchased through the mail service program will be covered as follows:
$10 copayment generic.
$40 copayment brand formulary (currently $30 copayment).
$70 copayment brand nonformulary (currently $60 copayment).
90 day supply.
There will be no changes till January 1, 2009.
